Recognition of Prior Learning

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Oxford University *

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INTERNATIO

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Nursing

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Nov 24, 2024

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Recognition of Prior Learning 1 Recognition of Prior Learning Student’s Name Instructor’s Name Course ID and Name Date

Recognition of Prior Learning 2 Introduction Recognition of Prior Learning (RPL) is a critical concept in healthcare. It is crucial in understanding an individual's health status, which is vital in understanding and caring for the vulnerable and ageing population. RPL incorporates validation and evaluation of an individual's pre-existing knowledge, competencies, and experiences, exerting profound influence over their present health and well-being outcomes. This assessment explores the complex aspects of RPL by focusing on and analysing the case of Elizabeth, an octogenarian female struggling with multiple health challenges. Elizabeth's narrative underscores the importance of recognising prior learning in health. She suffered two heart attacks and a recent diagnosis of dementia. This case is a microcosm that helps this study dissect different aspects of RPL through understanding her experiences and circumstances affecting her health status and overall well-being. The assessment analyses epidemiology, demography, genomics and other determinants of health. It highlights their importance in comprehending health issues and linking global health patterns. Furthermore, the assessment explains factors that cause health disparities, such as social, economic, and cultural determinants. This section will also explain social influences, investigating their role in sculpting health behaviours and outcomes in specific populations such as the geriatric demographic. The Recognition of Prior Learning (RPL) process, when applied to the case of Elizabeth, an 82-year-old female, reveals critical insights into the complicated determinants of health. By exploring the intersections of epidemiology, demography, genomics, and global health and analysing the factors contributing to health inequalities, one can discern the significance of social influences, health literacy, and individual circumstances. This assessment offers an understanding of Elizabeth's health status and underscores the importance of recognising prior learning in comprehending health outcomes among elderly populations. It

Recognition of Prior Learning 3 highlights the urgency of implementing interventions and strategies to address health disparities, enhancing their well-being. Epidemiology, Demography, Genomics, and Global Health Epidemiology, demography, and genomics are integral components in comprehending health on a global scale. Epidemiology is a foundational discipline in public health which examines patterns, causes, and effects of health and disease in populations (Coggon et al., 2023, p 3). It provides helps explain the distribution of diseases and health outcomes. As such, epidemiology is crucial in the development of evidence-based healthcare interventions. Epidemiological data is often derived from longitudinal studies and surveillance, guiding policymakers and healthcare practitioners in strategic intervention (Brachman, 2022). For example, epidemiological studies have shown the increased prevalence of chronic diseases in older populations, highlighting the healthcare needs of ageing individuals like Elizabeth. Epidemiologists work properly when considering demographics. Demography is the statistical study of populations. It considers aspects such as size, distribution, composition, and dynamics (Choi et al., 2019). Understanding demographic trends is vital in creating healthcare systems that meet the evolving needs of different groups. For instance, as the global population ages, demographic data informs policymakers and healthcare providers about the projected rise in elderly populations and the subsequent demand for specialised healthcare services and geriatric care (Nicolò et al., 2022). This demographic shift underscores the importance of recognising prior learning in healthcare, as it aligns services with the unique needs of ageing individuals. On the other hand, epidemiologists also consider the changing genomes among populations. Genomics is increasingly becoming relevant in healthcare. It studies individuals' genes and disease interactions (William, 2020, 5). Genomic research helps in the creation and

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Recognition of Prior Learning 4 development of personalised medicine. It enables healthcare providers and researchers to modify treatments based on an individual's genetic makeup (Ma & Shen, 2020, 324). Genomic data are significant in understanding the genetic predispositions of ageing individuals to various health conditions. This knowledge aids in risk assessment, prevention, and management strategies. Therefore, when exploring global health and well-being outcomes patterns, one has to observe the complex epidemiological, genealogical, and demographical landscape. Ageing populations in many parts of the world face distinctive health challenges. Epidemiological studies have revealed a higher burden of non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, and dementia, among older individuals ( (Ma & Shen, 2020). This demographic transition necessitates healthcare systems that cater to chronic conditions and prioritise preventive care. It allows policymakers to formulate mitigative strategies based on their understanding of genome research and their recognition of the challenges of linking treatment to a specific demographic (Brachman, 2022). For instance, treatment for Elizabeth would consider her demography, epidemiological data of her population, and past health information. While considering her treatment, one would have to recognise the challenge of treating the elderly and how it affects Elizabeth’s treatment. Moreover, when examining global health patterns, one notices apparent health disparities. Access to healthcare resources and quality of care vary significantly across regions, exacerbating inequalities in health outcomes. Inequities are more pronounced among vulnerable and ageing populations (Coggon et al., 2023). The ageing population finds challenges accessing specialised geriatric care, diagnostic services, and healthcare facilities. This global perspective underscores the importance of recognising prior learning, as it demands a comprehensive approach to healthcare delivery that addresses diverse needs within ageing populations worldwide (Brachman, 2022). RPL recognises the need to review healthcare responses to create an inclusive

Recognition of Prior Learning 5 and multidimensional approach that analyses epidemiological data, genomics, and demographic data when creating an intervention, especially for the ageing population. Factors Leading to Inequalities in Health Outcomes Health inequalities are universal and multidimensional, arising from a complex interrelation of various determinants. These factors include social, economic, and cultural determinants. Social determinants cover a range of societal factors that influence health outcomes. These determinants include education, employment, income, and social support networks (Paavola, 2017). Insufficient access to quality education leads to limited health literacy and awareness, hindering individuals from making informed health choices. Employment status and income level directly impact access to healthcare services, nutrition, and overall living conditions. For instance, more than 10% of the UK population cannot access quality healthcare due to low income (Ralston, 2022). At least 38 per cent of this population comprises the elderly who cannot afford necessary medications or nutritious food, thus increasing their susceptibility to health issues. Robust social support networks are pivotal for mental health, providing emotional resilience and assistance during illness (Ralston, 2022). Individuals from lower socioeconomic status are more likely to experience poor health outcomes, regardless of age or gender. Empirical studies have consistently shown that individuals with stronger social ties tend to have better mental health outcomes and a higher quality of life. Economic determinants are crucial in defining health disparities. Poverty, income inequality, and access to healthcare resources are central economic factors influencing health outcomes. Poverty, in particular, is a powerful determinant of health inequalities. At least 14 million people in the UK live below or below the poverty line. More than 48 % of this population comprises children and the elderly, who cannot access quality healthcare, housing, and nutrition (Bambra et al., 2019). This results in higher rates of chronic diseases, inadequate

Recognition of Prior Learning 6 prenatal care, and limited mental health services utilisation. Income inequality further exacerbates health disparities, creating stark contrasts in healthcare access and outcomes between affluent and disadvantaged populations. In the UK, only the top 35 per cent of the population on the income ladder have absolute access to quality healthcare (Ralston, 2022). Most Elderly, such as Elizabeth, cannot access healthcare services. Studies have shown a strong correlation between income inequality and various health indicators, including life expectancy and rates of chronic diseases. Cultural determinants, which include cultural beliefs, traditions, and practices, contribute to health inequalities. Cultural factors influence health behaviours, healthcare utilisation, and even perceptions of health and illness. Cultural beliefs may also influence healthcare-seeking behaviours; some communities may rely more on traditional healers than conventional medical practitioners. Multiple studies in the UK have shown disparities in health outcomes among culturally diverse populations (Bambra et al., 2019). For example, traditions regarding diet and physical activity impact the prevalence of conditions such as obesity and type 2 diabetes. In the UK, at least more than 4 % per cent of the population has specific cultural traditions directing healthcare and related activities (Singer et al., 2019). Therefore, having cultural competence on healthcare issues is crucial to bridge cultural gaps and ensure equitable access to care. It ensures the community knows the importance of quality healthcare and its relation to culture. Other determinants of healthcare in the UK include age, gender, and socioeconomic status. Ageing individuals such as Elizabeth’s demography often face a higher burden of chronic diseases and may have limited access to specialised geriatric care. According to the Health Foundation, the UK has an ageing population, with the elderly expected to rise by 2.5 million by 2040 (Ralston, 2022, 33). However, the UK health system is not changing to accommodate this demographic change. In addition, gender disparities persist in healthcare, visible through

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Recognition of Prior Learning 7 treatment and health-seeking behaviours (Khezrian, 2020). Gender disparities in heart disease prevalence and management are well-documented, with women often receiving less aggressive treatment for cardiovascular conditions compared to men. According to UK Health, men are more likely to seek treatment for sexually transmitted diseases than women (Kivimaki, 2020). These discrepancies have become part of the UK healthcare system. For instance, women are more likely to seek preventive care and have higher healthcare utilisation rates, while men often delay seeking medical attention. Understanding the impact of these determinants allows for creating interventions to target the specific population. Social Influences and Health Literacy Social influences are pivotal in shaping health behaviours and outcomes among the elderly. Elizabeth's case exemplifies how social factors can impact health decisions. Her limited social interactions and feelings of isolation affect her mental and emotional well-being. The lack of regular social engagement may contribute to depression, anxiety, and a decreased quality of life, which can have tangible effects on her overall health. UK health also shows that 15% of elderly hospitalizations across the UK result from recurring conditions (Kimaviki et al., 2020, e142). Elizabeth’s isolation has led to the recurrence of different health issues, affecting her ability to live a normal and fulfilling life, as evidenced by the two heart attacks she recently experienced and her continued visitation at healthcare centres. According to the World Health Organisation, isolation remains a major causative factor in chronic illnesses among the elderly (Singer et al., 2019). Therefore, policymakers must understand and train the community on the importance of social influences in shaping healthcare outcomes. In addition, health literacy is a critical determinant of health outcomes, particularly in managing health conditions among the elderly. As shown by the requirements and values of the Nursing and Midwifery Council UK (NMC) registered nurses in the UK, health literacy is a

Recognition of Prior Learning 8 fundamental component of nursing practice (Levin-Zamir et al., 2019). Nurses provide care and ensure that patients like Elizabeth comprehend their conditions, treatment plans, and the importance of adherence. Health literacy includes effective communication, providing written materials in plain language to patients and families, and adapting information to the individual's level of understanding (Centers for Disease Control, 2021). A member of the NMC would advise Elizabeth and her relatives on the importance of social inclusion and ensuring Elizabeth has social support. For Elizabeth and other elderly individuals, health literacy is pivotal in self- management and decision-making. Social support is crucial for the mental and physical health of the elderly, especially those facing recurring and chronic conditions such as Elizabeth. Research findings emphasize that social support networks can buffer patients, vulnerable individuals and the elderly against the negative impact of health issues. For Elizabeth, having a strong social support system can mitigate the effects of isolation and cognitive decline associated with dementia (Centers for Disease Control, 2021). Social support provides emotional comfort and can enhance medication adherence and encourage participation in physical activities. Elisabeth would need assistance and support from her relatives and family. They would have to be available at all times and whenever needed to ensure that she has the moral support and encouragement to ensure healthy living (Girommetti, 2022). Furthermore, social support creates belonging and purpose, which is particularly important for the elderly. The sense of belonging contributes to improved mental health and reduces the risk of depression, which may aggravate underlying health conditions. Besides, social interactions provide opportunities for physical activity and engagement in social activities, improving an individual's overall health. Different epidemiological research has shown that social support interventions improve health outcomes by reducing the recurrence of diseases and increasing mental health. For

Recognition of Prior Learning 9 instance, interventions designed to enhance social support for elderly individuals with chronic conditions can lead to reduced levels of depression, improved medication adherence, and better overall quality of life (Centers for Disease Control, 2021). These findings underscore the significance of healthcare professionals, including NMC registered nurses. These professionals are crucial in promoting social influence and creating patient support networks. As such, social influences promote health behaviours and outcomes, especially among the elderly (Levin-Zamir et al., 2019). Elizabeth's experiences emphasize how social isolation can affect mental and emotional well-being. In addition, health literacy is critical in managing health conditions, especially for individuals like Elizabeth (Centers for Disease Control, 2021). Besides, it plays a vital role in the practice of NMC registered nurses. Social support networks are integral for the elderly facing recurring and chronic conditions. It offers benefits that promote mental and physical health. Individual Circumstances, Behaviors, and Lifestyle Choices As exemplified by Elizabeth's case, individual circumstances and lifestyle choices impact an individual's health and may lead to the recurrence of a disease or condition. Elizabeth's living situation is characterised by her poor residence and limited social interactions, significantly impacting her health (Institute of Medicine, 2018). Living alone, especially in advanced age, can lead to social isolation leads to adverse health effects such as depression and cognitive decline. Elizabeth's case illustrates how her isolation contributes to feelings of loneliness and aggravates her dementia-related confusion. Academic studies on elderly populations have consistently demonstrated the detrimental effects of social isolation on mental health and cognitive function, underscoring the significance of individual living circumstances in shaping health outcomes. Family support, or the lack thereof, has played a pivotal role in Elizabeth's health. Her daughter's efforts to arrange her discharge from the hospital and provide follow-up input at a memory clinic

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Recognition of Prior Learning 10 have helped improve her condition and show the potential positive impact of family support (Institute of Medicine, 2018). Family members can facilitate access to healthcare services, ensure medication adherence, and offer emotional support, which is critical in managing chronic conditions like heart disease and dementia. Strong family networks can improve the well-being of elderly individuals facing complex health challenges. These networks are crucial in controlling infection as they ensure proper access to medical care and reduce the potential of a patient withdrawing from medical treatment (Institute of Medicine, 2018). They offer support essential to promoting mental wellness and reducing the impact of isolation and lack of proper care, especially among the elderly. Lifestyle choices and behaviours affect physical health. Elizabeth's case highlights how her lifestyle choices, such as diet and physical activity, can impact her overall health. Poor dietary choices and physical inactivity can intensify chronic conditions and contribute to cardiovascular issues (Pasion et al., 2020). The repetitive heart attacks affecting Elizabeth may be due to a lack of inactivity. For example, a sedentary lifestyle and an unbalanced diet are associated with a higher incidence of obesity, diabetes, and heart disease. In addition, lifestyle choices impact mental health (Edinger et al., 2021). In Elizabeth's case, her isolation and lack of engagement in social activities are lifestyle choices that can contribute to depression and anxiety. Social engagement and meaningful activities promote mental well-being among the elderly (Institute of Medicine, 2018). Elizabeth can enhance her mental health and improve her physical health by engaging in hobbies and participating in social groups. These activities can give her a sense of purpose and improve her lifestyle choices. Additionally, while not visible in Elizabeth, behaviours such as smoking and excessive alcohol consumption can harm physical and mental health and increase the risk of acquiring infections. Epidemiologists explain that alcohol and drug use increases the risk of accumulating

Recognition of Prior Learning 11 diseases (Institute of Medicine, 2018). They confirm an association between these behaviours and various health issues, including lung cancer, liver disease, diabetes, and increased rates of depression and anxiety (Centers for Disease Control, 2021). As illustrated by Elizabeth's case, individual circumstances, including living situations and family support, influence an individual's health. Often, isolation resulting from poor lifestyle choices, unsocial behaviours and lack of family support in elderly populations negatively impacts an elderly’s life, as seen in the case of Elizabeth (Levin-Zamir et al., 2019). Recognising and addressing these factors promotes the well-being of individuals like Elizabeth. However, there is a need to develop holistic healthcare approaches that consider the interplay of individual circumstances, lifestyle choices, and behaviours. These approaches should consider the epidemiological probability of diseases and infections affecting specific groupings, such as the elderly, and the best mechanisms to protect these demographics. Conclusion Focusing on the case of Elizabeth helps understand the link between demography, epidemiology, and other determinants of health. Besides, it has explained health inequality. Through Elizabeth's experiences, the essay has explored the complex connection between determinants of health and health disparities. The essay shows that social, economic, cultural, age-related, gender-related, and socioeconomic factors contribute to health inequalities. Different demographics are affected differently by these determinants. However, these factors contribute to understanding health care and combatting diseases and infections. In addition, the analysis has emphasised the role of social influences, such as social support networks and social isolation, in shaping health behaviours and outcomes, especially within the elderly population. It shows that having enough social support networks reduces the resurgence of infections, while social isolation leads to poor mental health. Lastly, the essay highlights the significance of health

Recognition of Prior Learning 12 literacy in effectively managing health conditions, particularly among the NMC registered nurses in the UK. NMC registered nurses help underscore the value of self-care. It is crucial to understand the importance of prior learning and applying it to understanding health outcomes because it enables the development of targeted interventions and strategies for addressing health inequalities. It also promotes the improvement of patients, improving the well- being of individuals like Elizabeth. RPL is also efficient in disease and infection control as it helps identify causative issues and effective intervention. These interventions may include enhancing social support networks, promoting health literacy, and encouraging healthy lifestyle choices. By addressing determinants of health inequalities, policymakers can develop a more equitable healthcare system that ensures optimal health and well-being for all individuals, regardless of their background or circumstances.

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Recognition of Prior Learning 13 References Brachman., P. S., 2022. Epidemiology. In: Medical Microbiology. 4th ed. s.l.:National Library of Medicine. Centers of Disease Control, 2021. Health Literacy: Solid Facts. s.l.:World Health Organisation. Choi, P. M., Tscharke, B., Samanipour, S. & O’Brien, J. W., 2019. Social, demographic, and economic correlates of food and chemical consumption measured by wastewater-based epidemiology. PNAS, 116(43). Coggon, D., Rose, G. & Barker, D., 2023. What is Epidemiology. In: Epidemiology for the uninitiated. 4th ed. s.l.:BMJ. Edinger, J.D. et al. (2021) “Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline,” Journal of Clinical Sleep Medicine , 17(2), pp. 255–262. Available at: https://doi.org/10.5664/jcsm.8986. Girometti, N. et al. (2022) “Demographic and clinical characteristics of confirmed human monkeypox virus cases in individuals attending a sexual health centre in London, UK: an observational analysis,” Lancet Infectious Diseases , 22(9), pp. 1321–1328. Available at: https://doi.org/10.1016/s1473-3099 (22)00411-x. Institute of Medicine, 2018. The Future of the Public's Health in the 21st Century. 5th ed. s.l.:National Academies Press. Khezrian, M. et al. (2020) “An overview of prevalence, determinants and health outcomes of polypharmacy,” Therapeutic Advances in Drug Safety , 11, p. 204209862093374. Available at: https://doi.org/10.1177/2042098620933741. Kivimäki, M. et al. (2020) “Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study,” The Lancet.

Recognition of Prior Learning 14 Public Health , 5(3), pp. e140–e149. Available at: https://doi.org/10.1016/s2468-2667 (19)30248-8. Levin-Zamir, D., Nutbeam, D. & Rowlands, G., 2019. Health Literacy in Context- Settings, Media, and Populations. s.l.:MDPI AG. Ma, H. and Shen, H. (2020) “From human genome epidemiology to systems epidemiology: current progress and future perspective,” Journal of Nanjing Medical University , 34(5), p. 323. Available at: https://doi.org/10.7555/jbr.34.20200027. Paavola, J. (2017) “Health impacts of climate change and health and social inequalities in the UK,” Environmental Health , 16(S1). Available at: https://doi.org/10.1186/s12940-017- 0328-z. Pasion, R. et al. (2020) “The AGE Effect on protective Behaviors during the COVID-19 Outbreak: Sociodemographic, perceptions and psychological accounts,” Frontiers in Psychology , 11. Available at: https://doi.org/10.3389/fpsyg.2020.561785. Ralston, R. et al. (2022) “Levelling up the UK: is the government serious about reducing regional inequalities in health?” BMJ , p. e070589. Available at: https://doi.org/10.1136/bmj-2022-070589. Singer, L. et al. (2019) “Social determinants of multimorbidity and multiple functional limitations among the ageing population of England, 2002–2015,” SSM-Population Health , 8, p. 100413. Available at: https://doi.org/10.1016/j.ssmph.2019.100413. VanderWeele, T.J. et al. (2020) “Positive epidemiology?” Epidemiology , 31(2), pp. 189–193. Available at: https://doi.org/10.1097/ede.0000000000001147. Williams, G.A. (2020) Annex A: What is genomics? Definitions and applications . Available at: https://www.ncbi.nlm.nih.gov/books/NBK569502/.

Recognition of Prior Learning

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